Report worsening or persistent heartburn beyond 2 weeks of self-treatment.
Before you read
Test yourself first: 3 questions
Question 1 of 3
A home care nurse is teaching a client about a new prescription for oral iron supplements for iron-deficiency anemia. Which instruction enhances iron absorption?
Answer: B. Taking iron with a source of vitamin C, such as orange juice, enhances absorption. Iron is best absorbed on an empty stomach, though it may be taken with food if GI upset occurs. Milk, antacids, and tea reduce absorption and should be avoided around the time of dosing.
Question 2 of 3
A nurse teaches a client prescribed oral ferrous sulfate for iron deficiency anemia. Which instruction is appropriate?
Answer: C. Iron is best absorbed on an empty stomach and absorption is enhanced by vitamin C (for example, taking it with orange juice). Clients should be told stools may turn black, to avoid taking it with milk, antacids, or tea (which reduce absorption), and to use a straw with liquid forms to prevent tooth staining. Taking iron with vitamin C is the correct teaching.
Question 3 of 3
A client prescribed tetracycline should be taught to:
Answer: B. Avoid taking it with dairy, antacids, or iron (they bind it and reduce absorption), use sun protection (photosensitivity), and avoid it in pregnancy/young children (teeth staining).
Keep the streak going with more questions like these, each with a full rationale.
What is antacids?
Common types include calcium carbonate, magnesium hydroxide, aluminum hydroxide, and sodium bicarbonate. Memory aid: magnesium causes diarrhea ('Mg = Must Go') and aluminum/calcium cause constipation, so they are often combined.
Key points to remember
- Provide fast but brief relief by neutralizing acid already present in the stomach.
- Magnesium-based products cause diarrhea, while aluminum- and calcium-based products cause constipation.
- Calcium carbonate can cause rebound acid hypersecretion and, in excess, milk-alkali syndrome with hypercalcemia.
- Magnesium antacids are dangerous in renal impairment due to magnesium accumulation.
- Antacids reduce absorption of many drugs (tetracyclines, fluoroquinolones, levothyroxine, iron, digoxin).
- Sodium bicarbonate adds a high sodium load, a concern in heart failure and hypertension.
Nursing priorities
- Separate antacids from other oral medications by 1 to 2 hours.
- Assess kidney function before giving magnesium-containing antacids.
- Monitor bowel pattern and adjust the type if diarrhea or constipation develops.
- Monitor calcium and magnesium levels with frequent use.
- Assess sodium content for patients with heart failure or hypertension.
Labs & values
Patient teaching
- Take other medicines 1 to 2 hours apart from antacids.
- Choose magnesium products if constipated and aluminum/calcium if loose stools occur.
- Limit sodium bicarbonate if you have heart failure or high blood pressure.
- See your provider if heartburn lasts more than 2 weeks.
Red flags: report now
- Report worsening or persistent heartburn beyond 2 weeks of self-treatment.
- Report confusion, weakness, or palpitations from electrolyte disturbance (hypermagnesemia/hypercalcemia).
- Never give magnesium-based antacids to patients with renal failure.
References
Clinical references for this topic
